Cracked Tooth

Treatment Outcomes

As previously mentioned, patients with cracked tooth will require a metal band placement to serve as a brace to splint the crack(s) and prevent further progression of the crack. When treated early, the pulp inflammation associated with cracked tooth is usually reversible. A local study[i] conducted in 2022 in NDCS, which assessed 122 cracked teeth with reversible pulp inflammation after orthodontic band placement in NDCS , found that 113 (92.6%) cracked teeth had pulp inflammation resolved within 2 months. The metal band would then be replaced by a permanent crown which helps to provide protection and retard the progression of crack.

If there are signs and / or symptoms of disease in the pulp, which gives rise to severe spontaneous pain, root canal treatment will be required. A local study[ii] done in NDCS in 2019, evaluated the incidence of pulpal complications in vital cracked teeth which had undergone band and crown placement. Out of 199 cracked teeth, 141 teeth (71%) remained healthy after 3 years without treatment, while 58 of them (29.1%) subsequently developed pulpal complications within 1-2 years, hence requiring root canal treatment or extraction.

Another local study[iii] done in NDCS in 2016 assessed the survival of cracked premolars and molars after root canal treatment at NDCS. It was found that 77 of 84 cracked teeth (92%) survived after 5 years, while 7 (8%) teeth were extracted. This showed that an endodontically treated cracked tooth is functional and may reasonably survive for 5 years and longer. The determining factor hinges on the extent of crack. Deep crack lines had a negative impact on teeth survival rate.

[i] Seet RF, Chan PY, Khoo ST, Yu VSH, Lui JN. Characteristics of Cracked Teeth with Reversible Pulpitis After Orthodontic Banding-A Prospective Cohort Study. J Endod. 2022 Dec;48(12):1476-1485.e1. doi: 10.1016/j.joen.2022.09.002. Epub 2022 Sep 21. PMID: 36150561. 

[ii] Wu S, Lew HP, Chen NN. Incidence of Pulpal Complications after Diagnosis of Vital Cracked Teeth. J Endod. 2019 May;45(5):521-525. doi: 10.1016/j.joen.2019.02.003. Epub 2019 Mar 22. PMID: 30905570. 

[iii] Sim IG, Lim TS, Krishnaswamy G, Chen NN. Decision Making for Retention of Endodontically Treated Posterior Cracked Teeth: A 5-year Follow-up Study. J Endod. 2016 Feb;42(2):225-9. doi: 10.1016/j.joen.2015.11.011. Epub 2015 Dec 23. PMID: 26723485.